Debra J. Saunders

 Not only did President George Bush and Sen. John Kerry drop the ball on the issue of health care in Wednesday night's presidential debate, but even moderator Bob Schieffer got it wrong when he said of health care, "We're paying more. We're getting less."

 I disagree. Most Americans are enjoying the best health care ever.

 The struggle today for most people isn't to get good care but to get other people to pay for their good health care. The great American pastime these days is to get someone else to pay for their doctor visits, drugs and hospital care.

 It doesn't matter if Americans can or can't afford to pay for their own health care. Affluent people, who happily dish out big dollars for meals and entertainment, bristle at the very notion that they should have to pay to take care of themselves.

 So neither Bush nor Kerry will level with voters to tell them about the consequences of the quest to shift the tab to someone else.

 I'll add, too, that neither guy wants to disclose that he can't deliver something for nothing.

 Bush? He loves health-savings accounts because they make people think about the cost of seeing a doctor, buying a drug or consulting a specialist. But he won't go out of his way to explain that his approach is predicated on an end to employer subsidies of health care -- because, when employers provide medical benefits, employees have little incentive to curb their spending.

 Bush is right to believe that consumers won't waste money if they are paying for day-to-day health expenses. And if he truly wants to upend the decades-long tradition of employers footing the health-care bill, he must know he has to stick out his neck to make the case to the voters. But he won't.

 So listen to Sally C. Pipes, president and CEO of the Pacific Research Institute in San Francisco and author of "Miracle Cure: How to Solve America's Health-Care Crisis and Why Canada Isn't the Answer," who notes that when employers provide health coverage, employees "overuse the system."

 To control costs, you either change the incentives or ration, notes Pipes, a Canadian who believes the governmental approach leads to rationing.

 Kerry? He says he won't expand government health care, but Wednesday night, he was promising health care for all -- even though his own policy briefs don't promise that much.

 Kerry talks as if more health care will be practically free. As Sen. Sophisticate explained, "If you diagnose diabetes early, you could save $50 billion in the health-care system of America by avoiding surgery and dialysis. It works."

 OK. Providing health care for more individuals may reduce the number of emergency-room visits, but providing health care to more individuals also means paying for those who come in for care and then ignore their doctors and end up in an ambulance. It also means paying for folks who go to the doctor with minor ailments -- rashes, digestive complaints -- that could have been resolved over the counter.

 Expanded health care also means providing pharmaceuticals, therapy sessions, a slew of diagnostic tests and other visits that you wouldn't have provided before -- which costs money. Before you know it, you've spent that $50 billion in savings -- or more.

 Kerry blames Bush for the 17 percent hike in Medicare premiums, and Bush blames Kerry for voting for the bill that triggered the increase. This is the first thing they've both done right, and neither wants to take credit for it.

 Another good thing: Washington is about to require seniors who earn more than $80,000 a year to pay higher Medicare premiums -- in other words, means testing. Neither candidate, alas, is demanding even more means testing.

 Pipes warns that just because a government promises health care for all, that doesn't mean everyone gets it. She notes the rationing that has plagued Canada's sick -- which is the possible cost of "free" health care.

 In the United States, you see citizens who enjoy the best health care in the world, and yet think they shouldn't have to shell out as much for it as they spend annually at restaurants.

 Why not? America's leaders won't go out on a limb to say health care costs money -- and it's worth every dime of it.


Debra J. Saunders


 
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